Squamous Cell Carcinoma arising in a mature cystic ovarian Teratoma with bladder invasion: a Case Report

Background: Malignant transformation in a mature cystic ovarian teratoma is rare. Except in cases with high index of suspicion or overt metastasis, oophorectomy is the mainstay of treatment for ovarian teratoma. Method: A 46-year-old perimenopausal woman who had salpingo-oophorectomy following a clinical diagnosis of benign ovarian tumour that was subsequently reported histologically as mature cystic ovarian teratoma with malignant transformation is presented. Results: She was referred to our facility based on the histopathology report and haematuria two weeks after surgery. Cystoscopic biopsy done was reported as metastatic squamous cell carcinoma most probably from the ovary. Patient was thereafter referred for radiotherapy but was lost to follow-up after the first course. Conclusion: Adequate evaluation prior to surgery in suspected ovarian teratoma with malignant transformation is critical to determine extent of surgery and adjuvant therapy. Prognosis in advanced disease condition such as the case presented is generally poor although radical pelvic surgery with resection of the adjacent involved bladder before radiotherapy would probably have improved her prognosis

Implementation of lean for small- and medium-sized construction organisational improvement

Purpose Small- and medium-sized enterprises (SMEs) within the construction sector are highly vulnerable to disruptions caused by political and economic decisions or even pandemics. This study evaluated the current operations of selected SMEs providing engineering design and consultancy services against Toyota Production System (TPS) lean tool. The purpose is to juxtapose SME operations and processes with TPS to ascertain the level of their operations conformity to the established TPS lean thinking tool. Design/methodology/approach This study used a qualitative data collection and analysis approach to evaluate the current processes of participating SMEs against Liker's 14 management principles of TPS. The data collected were analysed using thematic analysis to identify patterns and themes that emerged from the qualitative data. Findings The analysis revealed that focus on short-term goals, immediate profit and duplication of effort resulting from insufficient collaboration is currently creating waste in participating SMEs' operations. Hence, the implementation of TPS was recommended as a lean tool and a framework based on TPS lean tool was developed for improving the operations of SMEs. Research limitations/implications The study is limited to SMEs operating only as consultants providing project planning design within the construction industry. Data collection is limited to qualitative even though observations would improve the outcome of the study. Originality/value The study advances contemporary issues in promoting lean implementation in construction sector and developed an improved framework based on the TPS to enhance the performance of SME construction businesses